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Understanding Patella Luxation in Dogs and Cats: Causes Symptoms, and Treatment

Commonality: Moderate
Transmission: Not Contagious
Impact on Health: Medium to High
Symptoms: Intermittent limping, Skipping gait or difficulty walking, Pain and discomfort, Stiffness, particularly after rest
Abnormal posture (bow-legged or knock-kneed stance), Decreased activity levels, Swelling around the knee joint, Audible clicking or popping noises from the joint
Treatment Cost: $1,000 – $4,500+
Treatment and Recovery Time :  Surgical – 3-6 months for full recovery
Ease of Prevention: Medium
Most Affected Cat Breeds: Devon Rex and Abyssinian breeds
Most Affected Dog Breeds : Toy Poodles, Yorkshire Terriers, Chihuahuas, Pekingese, and Boston terriers and Pomeranians, Akita, Labrador, golden retriever, malamute, boxer, St. Bernard, and husky
Covered By Petsy : Yes, if not a pre-exisiting condition

Table of contents

What Is Patella Luxation

For The Non Vets

Think of patella luxation like a train sliding off its tracks. Imagine a kneecap (the train) travels smoothly along smoothly along the grove of the thigh bone (the train tracks) which allows your leg to extend and bend 1. When your pet has patella luxation, the kneecap also scientifically known as the Patella, slides off this track, leading to limping or awkward movement, much like how a derailed train can’t move properly.

The Vets Response 

Patella luxation, commonly known as kneecap dislocation, is a condition where the patella (kneecap) dislocates or moves out of its normal alignment. This typically occurs because the patella does not stay within the groove of the femur (thigh bone) where it normally glides smoothly during movement. This condition can be caused by genetic factors, trauma, or developmental issues, and it is particularly common in small breed dogs but can also affect cats and large dog breeds.

Understanding Patella Luxation

Imagine the patella (kneecap) in its normal position and movement like a train running on a track. The patella is like the train, and the groove in the femur (thigh bone) where the patella sits is like the train track 2. Above the patella is the patellar ligament which is like the electricity lines of the train, which connects the large thigh muscle to the centre of the shinbone (tibia) 2. When the thigh muscles contract, the force is transmitted through the patellar ligament, pulling on the shinbone and resulting in the extension or straightening of the knee. In a healthy knee, the patella (train) moves smoothly up and down the groove (track) as the leg bends and straightens 2. This smooth movement helps protect the knee joint and ensures that the leg can move efficiently and without pain, much like how a train travelling smoothly on its track ensures efficient and safe transportation. When an animal is diagnosed with patella luxation, it’s like the train derailing from its track. Instead of the patella (train) staying in its groove (track), it slips off to one side (medial or lateral), causing instability and discomfort.

The type of derailment that occurs can be either medial or lateral.

Medial patella luxation (MPL) happens when the patella slips toward the inner side of the leg, which is more common overall and particularly prevalent in small dog breeds such as miniature and toy poodles, Yorkshire terriers, Toy Poodles, Yorkshire Terriers, Chihuahuas and Pomeranians, Pekingese, and Boston terriers2,3,4

Lateral patella luxation (LPL) occurs when the patella slips toward the outer side of the leg. While less common, it is more frequently seen in larger dog breeds or giant breed dogs, especially the St. Bernard 5,6
Both types cause significant discomfort and require appropriate veterinary care to manage and treat the condition.

Patella luxation can be present at birth, developed over time or acquired due to trauma: Genetics: Some individuals are born with genetic predispositions that lead to structural abnormalities in the leg bones. These abnormalities can affect the alignment and stability of the patella, making it more prone to luxation. This condition is more common in dog breeds such as Toy Poodles, Yorkshire Terriers, Chihuahuas and Pomeranians. In cat breeds this condition is more common in Devon Rex and Abyssinian cats 5,6 Trauma Trauma to the knee, such as a fall, direct blow, or sudden twist, can damage the patellar ligaments or surrounding structures5. This damage can cause the patella to dislocate or become unstable. Tears or strains in the ligaments that support the patella can lead to instability and increase the risk of luxation. Conformation Conformation issues relate to how the dog’s body is built and develops over time 2 . Abnormal development or alignment of the leg bones and joints can lead to patellar luxation. For instance, if a dog’s legs are bowed or the hip and thigh bones do not align correctly, this can put extra stress on the knee, causing the patella to luxate. Both genetics and conformation can independently or together affect how smoothly the train runs, just as both can influence the likelihood of patellar luxation in dogs and cats. Genetics provides the blueprint, while conformation determines how well the structure develops and functions over time.

Symptoms of Patella Luxation

Patella luxation can vary in severity, and the symptoms may range from mild to severe. Common signs that may indicate your pet is suffering from patella luxation include:

Common Symptoms Description
Intermittent Limping Especially after exercise or physical activity.
Skipping Gait Your pet may occasionally skip or hold up the affected leg for a few steps, then resume normal walking. This is often due to the patella temporarily slipping out of place and then returning to its normal position.
Difficulty Walking More severe luxation can cause a persistent limp or difficulty walking, running, or jumping.
Pain and Discomfort Signs of pain, such as yelping, whimpering, or reluctance to move, can occur when the patella dislocates.
Stiffness The affected leg may appear stiff, particularly after periods of rest.
Abnormal Posture Pets may adopt a bow-legged or knock-kneed stance due to the misalignment of the patella.
Decreased Activity Pets may become less active or reluctant to engage in physical activities they previously enjoyed.
Swelling In some cases, there may be visible swelling around the knee joint.
Creaking or Popping Sounds You might hear creaking or popping sounds from the knee joint when your pet moves

Diagnosis of Patella Luxation

Diagnosing patella luxation involves a combination of physical examinations and diagnostic imaging. 

Diagnosing patella luxation involves determining the severity of the condition and identifying the appropriate treatment plan. The severity of patella luxation is categorised into four grades, each indicating the extent of the displacement (how derailed the train is) and the associated symptoms.

Grading Severity

Common Symptoms Description
Grade 1 The patella can be manually luxated but returns to its normal position spontaneously. Pets may show intermittent lameness.
Grade 2 The patella luxates with flexion of the stifle (knee) and remains luxated until the leg is extended and rotated. Causes frequent lameness.
Grade 3 The patella is permanently luxated but can be manually reduced. This grade causes persistent lameness.
Grade 4 The patella is permanently luxated and cannot be manually reduced. Pets with Grade IV luxation often have severe lameness and may have difficulty walking.

Clinical Examination 

The veterinarian will perform a thorough physical examination of your pet, focusing on the knee joints. They will palpate the knee to check for instability and to determine if the patella can be manually luxated. The severity of the luxation will be assessed based on the grading system.

Physical Examination 

Gait Analysis: Observing your pet’s gait can provide valuable information about the presence and severity of patella luxation. The veterinarian will look for signs such as intermittent limping, skipping gait, and abnormal posture.

Imaging 

X-Rays (Radiographs): X-rays of the knee joint are often taken to assess the alignment of the patella and the condition of the trochlear groove. This helps to confirm the diagnosis and to identify any associated abnormalities, such as arthritis or bone deformities.

Advanced Imaging : In some cases, more advanced imaging techniques such as CT scans or MRI may be used to provide a detailed view of the knee joint structures. This is particularly useful in complex cases or when planning surgical intervention.

Treatment and Recovery of Patella Luxation

Treating patella luxation involves both non-surgical and surgical options, depending on the severity of the condition and the overall health of the pet. The primary goals of treatment are to reduce pain, improve joint stability, and enhance the pet’s quality of life.

Non- Surgical – Conservative Therapies

For mild cases of patella luxation (typically Grade I and some Grade II cases), non-surgical treatments may be sufficient 9. With non-surgical treatments, recovery involves ongoing and consistent management. Regular follow-ups with the veterinarian are necessary to monitor the condition and adjust treatments as needed.
Conserative Therapies Description
Weight Management Maintaining an ideal weight helps reduce stress on the knee joints. Obesity can exacerbate the symptoms of patella luxation9.
Exercise and Physical Therapy Controlled exercise helps strengthen the muscles around the knee and improve joint stability. Activities such as swimming and walking on soft surfaces are beneficial9. Physical therapy may include specific exercises to strengthen the quadriceps and hamstring muscles, which support the patella.
Medications Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed to reduce pain and inflammation. Other pain relievers may also be recommended9.
Joint Supplements Nutritional supplements like glucosamine and chondroitin can support joint health and reduce inflammation.
Lifestyle Modifications Providing soft bedding, using ramps to avoid stairs, and avoiding high-impact activities can help manage symptoms and reduce the risk of further injury.

Surgical Treatment

For more severe cases of patella luxation (typically Grade II, III, and IV), surgical intervention may be necessary to correct the alignment of the patella and stabilise the knee joint. Here are the main surgical treatments:

1. Medial or Lateral Release:

Description

This is often the first step to alleviate tension from overly tight tissues pulling the patella out of alignment8. It helps to balance the forces acting on the patella. By releasing these tight tissues on the side of the knee where the luxation occurs (medial for inward, lateral for outward), the patella can move more freely within the trochlear groove, reducing the tendency to dislocate.


Rehabilitation for Juvenile Pubic Symphysiodesis

The recovery period is generally shorter compared to other surgical procedures. Approximate recovery time is 6-8 weeks. The initial 2 weeks include strict resting, followed by a gradual increase in activity. The gradual increase focuses on gentle range-of-motion exercises to prevent stiffness and promote healing over the remaining weeks.

2. Tibial Tuberosity Transposition (TTT)

Description By moving the attachment point of the patellar ligament, this procedure changes the mechanics of the knee joint 8 . It ensures that the patella is pulled in a more optimal direction, preventing it from luxating 9. This helps to realign the pull of the quadriceps muscle group, ensuring the patella tracks correctly within the trochlear groove. Aftercare/Rehabilitation of TTT Recovery time is generally longer due to the bone healing required at the site of tibial attachment. Approximate recovery time is 8-12 weeks. The initial 4-8 weeks will include strict confinement for healing, followed by gradual reintroduction to normal activities9. Rehabilitation activities emphasise weight-bearing exercises and controlled movements to support bone healing and proper alignment.

3.Trochleoplasty

Description Trochleoplasty involves deepening the trochlear groove, which is the groove in the femur where the patella sits and moves . By creating a deeper groove, the patella is less likely to slip out of place during movement. This procedure can involve various techniques such as wedge recession, block recession, or abrasion trochleoplasty, depending on the specific case 8,9   Aftercare/Rehabilitation Approximate recovery time is 8-10 weeks as it focuses on healing the surgically modified bone. The pet will follow strict initial confinement for 4-6 weeks, followed by a combination of range-of-motion and strengthening exercises to ensure proper patellar tracking and joint stability.

4.Soft Tissue Reconstruction

Description This involves tightening or reconstructing the ligaments around the knee to provide additional stability to the patella 8,9. The surgery can include techniques like imbrication (overlapping and suturing) of stretched ligaments or using grafts to replace or reinforce damaged ligaments. This helps to maintain proper patellar alignment and prevent luxation. Aftercare/Rehabilitation Recovery time varies based on the extent of the soft tissue work, but generally, the recovery time is 8-12 weeks. Post-operative care will include 4-6 weeks of initial strict rest, followed by a gradual return to activity focusing on strengthening the surrounding muscles and ligaments to provide additional support to the knee.

Cost of Treatment

The cost of treating patella luxation in dogs and cats can vary widely based on the severity of the condition, the chosen treatment method, and the geographic location. Patellar luxation surgery can cost anywhere between $1,000 and $5,000 per affected knee with addition of veterinary vet checkups, physical therapies, and medications 6. Financial preparedness is essential, and options such as pet health insurance, savings funds, and payment plans can help manage these potential expenses. Early diagnosis and appropriate treatment can significantly improve your pet’s quality of life, so consulting with a veterinarian for an accurate diagnosis and tailored treatment plan is crucial. Disclaimer : These costs can vary based on the veterinary practice and the specific needs of the pet.

Prevention Tips

While some cases of patella luxation are genetic and cannot be entirely prevented, there are several steps you can take to reduce the risk and manage the condition in dogs and cats 11: Maintain a healthy weight Excess weight puts additional stress on the knee joints, increasing the risk of patella luxation.Ensure your pet maintains an ideal weight through a balanced diet and regular exercise 12. Regular, controlled exercise Regular, controlled exercise helps maintain muscle strength and joint flexibility. Engage your pet in low-impact activities such as swimming and walking on soft surfaces. Avoid high-impact exercises that can strain the joints, especially in growing puppies.Excessive or intense physical activity can harm developing joints 11. Provide Proper Nutrition Provide Proper A diet rich in essential nutrients supports overall joint health.Feed your pet a high-quality diet appropriate for their age, size, and breed. Feed your pet a high-quality diet appropriate for their age, size, and breed. Consider supplements like glucosamine and chondroitin to support joint health 12. Regular Veterinary Check-ups: Early diagnosis and intervention can prevent the condition from worsening. Schedule regular veterinary check-ups to monitor your pet’s joint health and catch any early signs of patella luxation 11. Environmental Management: Providing a safe and supportive environment helps reduce joint stress11. Use ramps to help your pet avoid stairs, provide soft and supportive bedding, and keep floors non-slippery to prevent falls and injuries.

Getting Patella Luxation Covered with Pet Insurance

What is Petsy Pet Insurance? 

Petsy Pet Insurance is an insurance policy that reimburses 80% or 90% of vet costs for the treatment of your pet if they suffer an unexpected injury or illness (provided these occur after any applicable exclusion period has ended symptom free).

Our policy is customisable and you’ll be able to tailor the level of coverage, based on your preferences for the Benefit Percentage, Annual Limit, Annual Excess, whether or not you’d like Optional Extra Benefits (if your pet is less than 3 years old) and whether or not you’d like to include costs of Vet Consultations for your cover.

You get to see a summary of the cover when completing an online quote and have the option to select a preferred start date. After making the payment, you’ll receive a confirmation of cover and your policy documents by email. 

For added peace of mind, we offer a complimentary Pre-Existing Condition Assessment for all our members. This includes collecting your pet’s vet history upfront which helps to fast-track any future claims and we’ll also let you know whether there are any pre-existing conditions noted in their medical history that might affect your ongoing coverage. 

Claims are quick and easy, and your vet can submit claims on your behalf. Approved claims are paid into your nominated bank account.

What is a pre-existing condition? 

Under the terms of the policy, Pre-existing Condition is defined as:

An Injury, Illness, Dental Illness, Behavioural Condition or Specified Condition (including Bilateral Conditions, recurrent Conditions and other conditions that are related to, secondary to, or results of) that:

  1. first occurred or showed symptoms of; or
  2. was identified or investigated by a Vet; or
  3. You were aware of or a reasonable person in the circumstances could be expected to have known about, before Your Pet’s First Date of Cover; before a change of coverage became effective, or during any applicable Exclusion Period.

Whether a condition is considered a pre-existing condition depends on when the signs or symptoms occurred and when the exclusion periods on your policy end. Anything that happened before the exclusion periods ended is considered a pre-existing condition because it started before your coverage began.

Covered by Petsy

We cover Patella Luxation as long as it’s not pre-existing condition and your pet hasn’t shown signs or symptoms of the condition within the exclusion period.

A specified condition includes specific health issues, including cruciate ligament damage, intervertebral disc disease (IVDD), hip dysplasia, patella luxation, elbow dysplasia, osteochondritis dissecans (OCD), cherry eye, entropion, ectropion, and lumps.

Patella Luxation is a specified condition that has a 6 month exclusion period.
Once this period has passed and as long as your pet hasn’t shown symptoms, we can help to cover the vet costs for unexpected injuries and illnesses like Patella Luxation.

Can Petsy Insurance Cover My Pet’s Hip Dysplasia?

It depends on when you started your policy. If the signs or symptoms of Patella Luxation appeared before your policy began or during the exclusion period, it won’t be covered. But if you had an active policy and Patella Luxation happened unexpectedly, we can help to cover the costs.

If you’re a Petsy customer and are unsure about your exclusion periods and when the symptoms first appeared, you can request a pre-existing condition assessment. We’ll reach out to your vet for your pet’s medical history and let you know if your policy can cover it.

If you’re considering Petsy Pet Insurance, you can also reach out to our customer care team on 1300 952 790 for more information.

Does Petsy cover Patella Luxation?

Yes, Patella Luxation is covered under our standard policy. However, we can’t cover it if it’s a pre-existing condition, for example, if signs or symptoms appeared before your policy started or during the exclusion period. Petsy is here to protect you against unexpected vet costs.

How Petsy Pet Insurance can help with Patella Luxation

At Petsy, we understand how difficult it is when your pet faces Patella Luxation. Our insurance can help cover the costs of treatment, but it’s important to start your policy early, before any signs or symptoms appear.

Stay alert to any signs of Patella Luxation, and seek veterinary care proactively. Catching things early can make a big difference in your pet’s well-being and help them receive the best possible care.

Waiver Form 

You can apply to reduce the 6-month exclusion period for Specified Conditions by using our Waiver Form. Simply take this form to your next vet visit and make sure to submit the completed form back to us within 14 days of the visit.

The conditions that this waiver applies to include cruciate ligament damage, intervertebral disc disease, hip dysplasia, patella luxation, elbow dysplasia, osteochondritis dissecans (OCD), cherry eye, entropion, ectropion, and lumps.

Here’s how to apply:

  • Fill out Part 1: You start by completing Part 1 of the form.
  • Vet Examination: Have your vet examine your pet and complete Part 2 of the form.
  • Submit the Form: Send the completed form along with your pet’s full veterinary history to us within 14 days of the examination.
  • Receive an updated Certificate of Insurance: Once the review is complete, we’ll issue an updated Certificate of Insurance detailing any reduced exclusion periods for specified conditions.

You can find the waiver form on our website under the ‘Policy Documents’ section, or contact us directly and we’ll send it to you.

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Conclusion

Patella luxation is a serious condition that can significantly impact the quality of life of pets, but with early detection and proper care, many animals can achieve a full recovery. At Petsy Pet Insurance, we understand the emotional and financial strain that patella luxation can place on pet owners. That’s why we’re committed to providing comprehensive coverage that supports not only the necessary treatments—from surgery to physical therapy—but also preventive care measures that can mitigate the risks associated with this condition.

We encourage pet owners to take proactive steps in maintaining their pet’s joint health through regular veterinary check-ups, appropriate exercise, and nutrition tailored to their breed’s specific needs. Additionally, using preventive aids like ramps and supportive bedding can further protect your pet from potential injuries.

Frequently Asked Questions

Patellar luxation signs include limping, reluctance to put weight on the affected leg, intermittent skipping or hopping, and sudden lameness episodes.

Diagnosis involves a physical examination by a vet, X-rays to assess the joint alignment, and sometimes additional tests like CT scans or arthroscopy.

Yes, untreated patellar luxation can cause arthritis, chronic pain, and mobility problems in pets as they age.

Treatment may involve medication for pain management, physiotherapy, weight management, or surgical correction depending on the severity of the condition.

With appropriate treatment and care, many pets can lead normal lives post-treatment, although some may require ongoing management for optimal quality of life.

References

  1. Medicine. 2023. Available from: https://www.vet.cornell.edu/departments-centers-and-institutes/riney-canine-health-center/canine-health-information/patellar-luxation#:~:text=Patellar%20luxation%20is%20a%20common
  2. L’Eplattenier, H. and Montavon, P., 2002. Patellar luxation in dogs and cats: pathogenesis and diagnosis. Compendium, 24(3), pp.234-240.
  3. Hayes AG, Boudrieau RJ, Hungerford LL. Frequency and distribution of medial and lateral patellar luxation in dogs: 124 cases (1982–1992). Journal of the American Veterinary Medical Association. 1994 Sep 1;205(5):716-20.
  4. Patellar Luxation Fact Sheet [Internet]. Davies Veterinary Specialists. Available from: https://www.vetspecialists.co.uk/fact-sheets-post/patellar-luxation-fact-sheet/
  5. Di Dona F, Della Valle G, Fatone G. Patellar luxation in dogs. Veterinary Medicine: Research and Reports. 2018 May 31:23-32.
  6. Di Dona F, Della Valle G, Balestriere C, Lamagna B, Meomartino L, Napoleone G, Lamagna F, Fatone G. Lateral patellar luxation in nine small breed dogs. Open Veterinary Journal. 2016 Dec 21;6(3):255-8.
  7. Arthurs GI, LANGLEY‐HOBBS SJ. Complications associated with corrective surgery for patellar luxation in 109 dogs. Veterinary surgery. 2006 Aug;35(6):559-66.
  8. Gibbons SE, Macias C, Tonzing MA, Pinchbeck GL, McKee WM. Patellar luxation in 70 large breed dogs. Journal of small animal practice. 2006 Jan;47(1):3-9.
  9. Fitzpatrick Referrals. Patellar luxation [Internet]. Fitzpatrick Referrals. [cited 2024 Jul 4]. Available from: https://www.fitzpatrickreferrals.co.uk/orthopaedics/patellar-luxation/#:~:text=Non%2Dsurgical%20treatments%20for%20patellar
  10. Melbourne Pet Surgery. Medially Luxating Patella (MLP) Dog Surgery & Cost [Internet]. Melbourne Pet Surgery. [cited 2024 Jul 4]. Available from: https://www.melbournepetsurgery.com.au/medially-luxating-patella-surgery-dogs
  11. L’Eplattenier H, Montavon P. Patellar luxation in dogs and cats: management and prevention. Compendium. 2002 Apr;24(4):292-300.
  12. Bond Vet. Luxating Patella in Dogs: Symptoms, Treatment Options & Prognosis [Internet]. Bond Vet. Available from: https://bondvet.com/b/luxating-patella-dog#:~:text=While%20you%20may%20not%20be
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Petsy Pty Ltd (ABN 54 633 343 058, AR 1277359) (‘Petsy’) distributes and promotes Petsy Pet Protection Plus (formally Petsy Pet Insurance), Petsy Puppy Protection Plus and Petsy Kitten Protection Plus as an authorised representative of ThePetInsuranceCompany.com.au Pty Ltd (ABN 38 620 795 735, AFSL 536651) (‘ThePetInsuranceCompany.com.au’). ThePetInsuranceCompany.com.au is an underwriting agency acting under a binding authority as an agent for the insurer; Pacific International Insurance Pty Limited (ABN 83 169 311 193, AFSL 523921) (‘Pacific).
In all aspects of arranging this product, Petsy and ThePetInsuranceCompany.com.au act as an agent of Pacific and not as your agent. Any advice contained in this email is general advice only and has been prepared without taking into account individual objectives, financial situation or needs and you should consider the appropriateness of any such advice, the Product Disclosure Statement (‘PDS’) and the Target Market Determination (‘TMD’) available via http://www.petsy.com.au or by calling 1300 952 790 before making a decision to acquire, or to continue to hold, the product. Terms, conditions, limits and exclusions apply. Please refer to the PDS.

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Specified Conditions includes:
  • Cruciate ligament damage
  • Intervertebral disc disease
  • Hip dysplasia
  • Patella luxation
  • Elbow dysplasia
  • Cherry eye
  • Entropion
  • Ectropion,
  • Osteochondritis dissecans (‘OCD’)
  • Lumps
Lumps means the protuberance or localised area of swelling or unusual growth that can occur anywhere on or in the body including tumours, warts, cysts, growths, mucoceles, haematomas and abscesses.
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Optional Extra Benefits

During the application process You will be provided with the option to include Optional Extra Benefits that cover certain conditions and Treatments which are not otherwise covered under the Policy.

The Optional Extra Benefits are:

Alternative Therapies, Behavioural Problems, and Dental Illness.

Examples of Alternative Therapies: Acupuncture, physiotherapy, hydrotherapy.

Examples of Behavioural Problems: Excessive licking, fur pulling, pacing and destructive chewing.

Examples of Dental Illnesses: Dental diseases, gingivitis, periodontal disease.